Claims and Value Based Care Finance Manager

HealthPartners • Bloomington, MN • 16h ago

HealthPartners is hiring Claims and Value Based Care Finance Manager. The Manage provider reimbursement and FP&A support of off-system payments, including value-based care (VBC) arrangements. Manage system changes related to non-standard provider reimbursements such as provider VBC arrangements. Responsible for estimating claims IBNR and claims performance reporting as part of month end process. MINIMUM QUALIFICATIONS: Education, Experience or Equivalent Combination: Bachelor's degree (Finance, Accounting, or related) with 5+ years of experience or 7+ years of equivalent experience Knowledge, Skills, and Abilities: Health Industry Experience Leadership experience Effective communication skills, written and oral High level of business and organization knowledge Excellent financial analysis skills Strong systems skills and ability to keep up to date with system changes PREFERRED QUALIFICATIONS: Knowledge, Skills, and Abilities: Health Plan Insurance experience Experience with Claims Forecasting and/or IBNR estimation ESSENTIAL DUTIES: (Includes duties that represent 10% or more of the role's time and focus) (20%) - Manage the month end review of claims lags and IBNR estimation process along with providing reporting/analysis of claims trends and performance Ensure IBNR calculations and process provide most reasonable estimates. Collaborate with Accounting and Actuarial departments review and calibration of estimates. Review high-cost claims and stop loss claims and follow up with appropriate areas to ensure we are reserving appropriately. Provide reporting and analysis on monthly claims trend performance, identifying key drivers and forecast variances (20%) - Off-system Claims General Ledger and FP&A Support Support accounting for off-system claims general ledger accruals and provide month end reporting. Provide financial planning and analysis support for budgeting/forecasting and reporting of off-system claims for health plan (e.g. VBC arrangements, non-adjudicate payment processes, provider settlements, non-claim medical expenses, etc.). Serve as subject-matter-expert and primary finance lead for ad-hoc analysis/projections for off-system claims and for provider contracting impacts/arrangement. Role may present opportunities to provide additional finance oversight/support for Medical/Rx claims forecasting/projections. (20%) - Provide oversight of the financial reporting for value-based care (VBC) arrangements Review VBC quarterly results for accuracy, timeliness and ensure appropriate controls are in place. Analyze and provide summary of key trends to review with Provider Relations/Network Management team Review of accruals and payments for provider value-based arrangements Effectively summarize and report on provider settlement information (15%) - Administer HealthPartners Provider Withhold settlement process. Ensure annual settlements for providers are completed accurately and all contractual deadlines are met for both provider and health plan groups. Oversee process of calculating annual settlements is efficient, and effective controls are in place. (15%) - Lead daily operations of Claims/Value-based Care Finance support team. * Manage team to provide work direction, training, cross-training, development and support. (10%) - Manage system changes related to provider value-based care (VBC) changes and withhold settlement process Understand systems that support provider value-based care payment arrangements Work with IT for any changes to provider VBC arrangements and ensure accuracy of changes through reviewing testing. Ensure financial reporting systems are efficient, and effective internal controls exist. Effectively work with Provider Relations/Network Management in a team approach to bring the settlement process to closure. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.

Similar Jobs

Chief Growth Officer- Tax Services

Eisner Advisory Group LLC • Minneapolis, MN • 14h ago

Finance, Accounting & Banking

Job Description At EisnerAmper, we look for individuals who welcome new ideas, encourage innovation, and are eager to make an impact. Whether you're starting out in your career or taking your next step as a seasoned prof...

14h ago

Go to Apply

Manager, Product Strategy - Tax Transformation

Deloitte • Minneapolis, MN • 14h ago

Finance, Accounting & Banking

The Tax Transformation Office serves Deloitte Tax, focused on Service Delivery Transformation inclusive of people, process, and technology in order for our Tax Professionals to deliver efficient, high value, quality tax...

14h ago

Go to Apply

Senior, Product Strategy Analyst - Tax Transformation

Deloitte • Minneapolis, MN • 14h ago

Finance, Accounting & Banking

14h ago

Go to Apply

Accounts Payable Supervisor

Egan Company • Champlin, MN • 16h ago

Finance, Accounting & Banking

Overview Egan Company is seeking candidates for an Accounts Payable Supervisor position located in Champlin, MN. The Accounts Payable Supervisor is responsible for overseeing the daily operations of the accounts payable...

16h ago

Go to Apply

Project Accountant

Wunderlich-Malec Engineering • Eden Prairie, MN • 16h ago

Finance, Accounting & Banking

Description Wunderlich-Malec Engineering (WM) is 100% employee-owned and one of the largest and most well-established engineering companies in the United States. When you join WM you become part of a company that is: 100...

16h ago

Go to Apply

Finance Business Partner

Mortenson Construction • Minneapolis, MN • 16h ago

Finance, Accounting & Banking

Finance Business Partner SUMMARY Mortenson is currently seeking a Finance Business Partner to support our Operating Groups. This individual will be responsible for leading the development and delivery of financial soluti...

16h ago

Go to Apply

Director, Finance Shared Services (Accounts Payable)

CHS Inc. • Inver Grove Heights, MN • 16h ago

Finance, Accounting & Banking

CHS Inc. is a leading global agribusiness owned by farmers, ranchers and cooperatives across the United States that provides grain, food and energy resources to businesses and consumers around the world. We serve agricul...

16h ago

Go to Apply

Underwriter III - Non-Delegated Mortgage

Western Alliance Bank • Bloomington, MN • 17h ago

Finance, Accounting & Banking

Job Title: Underwriter III - Non-Delegated Mortgage Location: Remote Florida What you'll do: A Mortgage Underwriter III is responsible for underwriting conventional loans by reviewing the credit, capacity, and collateral...

17h ago

Go to Apply

Commercial Underwriter III

Old National Bank • Minneapolis, MN • 17h ago

Finance, Accounting & Banking

17h ago

Go to Apply

Business Banking Portfolio Manager VP

Associated Bank National • Minneapolis, MN • 17h ago

Finance, Accounting & Banking

At Associated Bank we strive to create an inclusive culture where different perspectives are valued and recognized as strengths critical to our success. If you thrive in an environment where your growth and development a...

17h ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.